Individual
DR. ROBERT LOUIS CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3937 IVYWOOD LN, PUEBLO, CO 81005-2551
(719) 553-0111
(719) 553-0117
Mailing address
PO BOX 9000, PUEBLO, CO 81008-9000
(719) 553-0111
(719) 553-0117
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29798
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01297985
—
CO
Enumeration date
05/05/2006
Last updated
08/18/2010
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